Individual provider Active NPI

Rose Marie Ernest Roge, NP

  • Family Nurse Practitioner
  • Riverview, FL
National Provider Identifier
1124707898
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11027370 Issued in FL
Practice address
10640 Laguna Plains Dr
Riverview, FL 33578-0034
Phone
(786) 487-2325
NPI assigned
Jul 11, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11027370 FL Primary

Addresses

Primary practice location

10640 Laguna Plains Dr
Riverview, FL 33578-0034

Mailing address

10640 Laguna Plains Dr
Riverview, FL 33578-0034
Phone (786) 487-2325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250414002697 FL Practitioner - Nurse Practitioner 5092239863 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11027370FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Community Health LLC CurrentSince Apr 3, 2025 Accepting new patients

Locations

2150 S Congress Ave
Palm Springs, FL 33406
Phone (561) 508-7066

Interoperability endpoints

  • FHIR API: https://epicproxy.et1256.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1689033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1124707898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10640 LAGUNA PLAINS DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335780034",
            "telephone_number": "786-487-2325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10640 LAGUNA PLAINS DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335780034",
            "telephone_number": "786-487-2325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERNEST ROGE",
        "first_name": "ROSE",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-11",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11027370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverview, FL

Sources for this page

Verify at the official NPI Registry.